David Nott writes for The Mail on Sunday

Of all the wounded children of Aleppo who passed before me, the memory of one has lodged in my mind like no other. Madam. I spent the week before Christmas in a field hospital in Syria operating on many tiny souls see-sawing between life and death, their bodies held together with metal pins and scaffold-like fixators.

But in Maram, a five-month-old orphan and beautiful despite her injuries, I saw my own child and, perhaps because I missed her so desperately, I felt intensely overwhelmed.

I have made numerous trips to Syria to treat the casualties of this war, but none was as sorrowful as the week I spent with Aleppo’s children. Bone-weary and drained emotionally, I returned to London on Christmas Eve and couldn’t wait to hold my 17-month-old daughter and see my wife and family. Christmas was a joy.

Yet Maram was never far from my mind’s eye: a haunting, residual memory that I could not have shaken even if I had wished; I find myself waking in the early hours worrying about her. I first saw Maram on December 20, a few days after she was evacuated from Aleppo in an ambulance. Her legs and left arm had been shattered in a bomb attack that killed her parents and injured her brother and sister.

Pieces of ordnance shell were embedded in her infected wounds but, because the Aleppo doctors had run out of dressings, disinfectant and saline, they had no choice but to operate on her dirty body tissue. As I looked down at Maram on the treatment table she was crying, not because she was tired and hungry, even though she was both, but because she was in great pain.

There are no paediatricians in Aleppo, or at the hospital where I was working; nobody qualified to make the very difficult decisions about how much analgesics and fluids to dispense. So in spite of all her suffering, Maram was simply on a small dose of paracetamol. It was heartbreaking. I checked her charts. In the UK, these would have been filled in with scrupulous attention to detail, but in Syria, with doctors battling to save the lives of so many, charts were overlooked. I couldn’t even tell what medication she had already received.

Maram wriggled uncomfortably. I tried to think logically about how to help her and what I’d need to do when I operated on her the following day. But precise thought was difficult as I felt myself experiencing the same sort of emotions that any father would have towards a wounded child.

I operated on December 21, carefully debriding Maram’s wounds and removing the decaying tissue inside her. The whole hospital stank of the bacteria that had caused her infections, and those in other patients. I worked delicately around the open compound fracture Maram had suffered in her left leg.

Correctly in my opinion, the surgeon who had operated on her in Aleppo had applied an external fixator, but this was so big and heavy that Maram couldn’t move her leg when she was awake. It was so sad to see. She also had a pin in her femur and another in her tibia, and she had a really big gap of leg bone missing from the explosion.

Read more here.


  • Dr kaneshanathanMCSP, PHD,MBASEM. On September 1, 2017at 10:52 pm - Reply

    A truly heart breaking events
    Make us to Realise how lucky we are in the west and still complaining about the free facilities provided in the NHS by dedicated staff

  • Besta On January 27, 2018at 2:59 pm - Reply

    It is so sad story. Where she is now? Best of luck for you doctor.

Leave a Comment